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Week in Washington 12/12/24
Congress End of Year Bill – With about one week to go before Congress goes on recess for the remainder of the term there’s still no resolution on an end of year funding bill that would keep the government open. Observers are expecting that if there are health care changes this year they’ll be included ... Read more
Events & More
Considerations for a Potential State-Based Marketplace in Texas
The Urban Institute recently released a report examining the potential for a state-based marketplace in Texas with input from HMA’s Zachary Sherman, Managing Director and ACA marketplace expert. The Affordable Care Act created health insurance Marketplaces—government-operated entities with websites for purchasing health coverage, often with income-based premium subsidies. During the 2023 legislative session, Texas lawmakers introduced two bills to transition the state’s Marketplace from the federally facilitated Marketplace to a state-based Marketplace (SBM). This study summarizes and analyzes perspectives on a potential Texas transition to an SBM, including risks and benefits, best practices to mitigate risks to coverage if Texas elects to establish an SBM, and other measures to improve coverage.
Newsworthy Findings
New Bipartisan Legislation Would Force Insurers, PBMs to Sell Pharmacy Businesses
A bipartisan group of legislators is seeking to break up pharmacy benefit managers by forcing them to sell pharmacy businesses, in what experts described as Congress’ most radical attempt to reform the controversial drug middlemen to date.
Premiums Could Rise, Millions Could Lose Coverage if Enhanced ACA Subsidies Expire: CBO
The number of uninsured Americans will increase by 3.8 million on average each year from 2026 to 2034 if the subsidies lapse, according to an estimate by the Congressional Budget Office.
Federal Judge Halts Dreamers' Brand-New Access to ACA Enrollment in 19 States
A federal judge in North Dakota blocked a Biden administration rule allowing DACA recipients to enroll in Affordable Care Act plans in 19 states, prompting legal uncertainty and likely appeals over access to health coverage for “Dreamers.”
Penn Medicine Teams up with Mark Cuban Cost Plus Drug Company
Penn Medicine has partnered with Mark Cuban Cost Plus Drug Company to provide affordable, transparently priced generic medications across its retail pharmacy network, aiming to reduce costs and improve access for patients.
CMS Finalizes Organ Transplant Access Model
On November 26, the Centers for Medicare & Medicaid Services (CMS) finalized its Increasing Organ Transplant Access (IOTA) Model, which aims to increase access to kidney transplants for patients living with end-stage renal disease (ESRD).
Bonus Article
Trillions of Microscopic Sea Plankton Recruited to Solve the Carbon Problem
Just for Fun
Math Joke:
Why couldn’t the angle get a loan?
Prior Week
Q: Why did the boy refuse to drink the water with eight ice cubes in it?
A: Because it’s too cubed!
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